Analysis Of Risk Factors With Early Vascular Complications After Liver Transplantation

Objective:To explore the risk factors of vascular complications after liver transplantation,and to provide clinical evidence for the prevention and treatment of vascular complications after liver transplantation.Methods:The clinical data of a total of 128 liver transplant patients from 2016 to 2019 in Kunming First People’s Hospital were retrospectively analyzed.17 patients with vascular complications diagnosed by CDFI,CTA,and angiography as the case group,while 111 patients without vascular complications as the control group.Results:The total incidence of vascular complications was 13.3%,including 11 males and 6 females;age(37.18±15.67);6 cases of portal vein stenosis(4.8%),3 cases of hepatic artery thrombosis and portal vein thrombosis(2.4%),2 cases of hepatic artery stenosis and portal vein thrombosis(1.6%),2 cases of portal vein stenosis and inferior vena cava thrombosis(1.6%),1 case of portal vein thrombosis(0.8%),One patient had central hepatic vein and portal vein thrombosis(0.8%),one patient had a hepatic artery aneurysm(0.8%),and one patient had a hepatic artery hemorrhage(0.8%).(1).The early vascular complications are analyzed of a univariate analysis showed that the recipient age(37.17 ± 3.80),donor age(22.00 ± 3.82),recipient/donor weight ratio(1.58 ± 0.15),portal vein anastomotic diameter(0.84 ± 0.06),and donor/recipient portal diameter ratio(0.62± 0.05)were significantly associated with vascular complications in the univariate analysis(P<0.05).The recipient/donor weight ratio is an independent risk factor for vascular complications after liver transplantation(P=0.002).(2).Early hepatic artery complications are analyzed separately of a univariate analysis showed that the recipient age(36.00±5.82),donor age(20.57 ± 6.29),recipient/donor weight ratio(1.95 ± 0.22),and TACE before surgery were significantly associated with early hepatic artery complications(P<0.05).After analysis of the ROC curve showed that when the critical value of recipient/donor weight ratio is 1.425,the AUC value is 0.967,which indicates that the probability of hepatic artery vascular complications after liver transplantation is very high for diagnosis and prediction above the critical value.It has important clinical significance;(3).On the other hand,univariate analysis of portal vein complications alone obtained the result that the recipient age(35.40±4.11),donor age(20.40±3.88),recipient/donor weight ratio(1.52 ± 0.18),portal vein anastomotic diameter(0.87±0.0 6),donor/recipient portal vein diameter ratio(0.62 ± 0.06),preoperative portal vein thrombosis(P=0.042),and BMI<18.5(P=0.003)were significantly associated with portal vein complications(P<0.05).After Logistic regression analysis,the recipient age(P=0.022),recipient/donor weight ratio(P=0.021),BMI<18.5(P=0.019),and preoperative portal vein thrombosis(P=0.006)are the independent risk factors of portal vein complications after liver transplantation.Conclusion:(1).The occurrence of vascular complications after liver transplantation is related to the smaller recipient and donor age,bigger recipient/donor weight ratio,smaller portal vein anastomotic diameter and bigger gap of donor/recipient portal vein diameter.Recipient/donor weight ratio is the independent risk factor of vascular complications after liver transplantation.(2).The early hepatic artery complications after liver transplantation is related to the smaller recipient and donor age,bigger recipient/donor weight ratio and TACE before surgery.When the critical value of recipient/donor weight ratio is 1.425,the AUC value is 0.967,which indicates that the probability of hepatic artery vascular complications after liver transplantation is very high for diagnosis and prediction above the critical value.(3).The portal vein complications after liver transplantation is related to the smaller recipient and donor age,bigger recipient/donor weight ratio,smaller portal vein anastomotic diameter,preoperative portal vein thrombosis and BMI<18.5.The recipient age,recipient/donor weight ratio,BMI<18.5 and preoperative portal vein thrombosis are the independent risk factors of portal vein complications after liver transplantation.